ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychopathology
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1485460
This article is part of the Research TopicThe Heterogeneity of Psychiatric Symptoms and DisordersView all 17 articles
Characterizing Heterogeneity in Motivational Impairments in Psychosis
Provisionally accepted
- 1McLean Hospital, Belmont, United States
- 2Harvard Medical School, Boston, Massachusetts, United States
- 3Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
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Motivational impairments are a hallmark symptom of psychotic disorders. However, motivation is a multidimensional construct believed to be underpinned by different neural mechanisms and differentially impaired both between and within diagnostic groups. We used a data driven approach to identify different motivational profiles in people with psychosis.Participants (n=242) included people with a diagnosis of a DSM-V schizophrenia spectrum disorder (SSD; n=95), mood disorder with psychosis (MDP; n=95), and healthy controls (n=52).Participants were assessed using the Behavioral Inhibition/Behavioral Activation Scales (BIS/BAS), measures of clinical symptoms, assessments of hedonic capacity (anticipatory and consummatory pleasure; TEPS), and a behavioral task of effort expenditure for reward. The four BIS/BAS subscales from the patient groups were normed to the controls and entered first into a hierarchical cluster analysis, and then into K-means cluster analysis for the final cluster solution. A four-cluster solution best fit data, reflecting: a High Avoidance group (n=56); a High Approach group (n=66); a Low Approach/High Avoidance group (n=26); and a Low Approach group (n=35). Diagnostic groups were represented in each cluster. Clusters differed on depression and anxiety severity on both interview-based and self-report measures, as well as on anticipatory and consummatory pleasure. Contrary to our hypothesis, groups did not differ on a measure of community functioning. These findings suggest that aspects of approach and avoidance motivation may be both uniquely and additively associated with anxiety, depression, and hedonic experiences. Characterization of motivational profiles may help parse heterogeneity in motivation and predict other important aspects of illness. * p<.05 **p<.01 ***p<.001 * p<.05 ** p<.01 **** p<.0001
Keywords: Reward, Motivation, Schizophrenia, Bipolar Disorder, psychosis, Cluster analysis
Received: 23 Aug 2024; Accepted: 27 Mar 2025.
Copyright: © 2025 Lewandowski, Luo, Yao and Whitton. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kathryn Eve Lewandowski, McLean Hospital, Belmont, United States
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